Medical surveillance followed the U.S. OSHA standard: A study in large manufacturing factories, the Eastern Economic Corridor of Thailand
Keywords:
medical surveillance, health risk examination, U.S. OSHA standard, occupational health physicianAbstract
Medical surveillance is essential to protect employees at high risk of occupational diseases, particularly in the chemical industry. A comprehensive medical surveillance program has 14 key steps, with occupational health physicians (OHPs) playing a significant role. While the U.S. OSHA guidelines meet all requirements, Thailand’s legislation lacks essential elements, leading to potential negative consequences for companies. This study aims to 1) determine the proportion of large chemical manufacturers that follow the U.S. OSHA standard medical
surveillance program; and 2) to study the difference between the presence or absence of OHPs and compliance with U.S. OSHA standards. A cross-sectional study involving large chemical-using factories in Rayong, Chonburi, and Chachoengsao provinces (EEC area) was conducted from January to March 2022, with a sample size of 190 factories. The methodological steps included a literature review, the development of a 38-item questionnaire, content validity and test-retest reliability analysis. Finally, the questionnaire was completed by experienced respondents in various factories. The results showed that only 3.4% (95%CI: 1.1-8.9) of the surveyed factories implemented at least eight essential steps of the U.S. OSHA medical surveillance program. The most common three lowest substandard steps identified were designing medical surveillance at 12.6% (95%CI: 6.9-20.8), conducting walk-through surveys 25.3% (95%CI: 17.1-35.1), and medical recordkeeping 29.9% (95%CI: 21.0-40.0). The presence of OHPs significantly improved compliance rates in specific steps, such as conducting walk-through surveys (OR 4.33, 95%CI: 1.56-12.51, p=0.003) and design for the components of the medical surveillance program (OR 20.71, 95%CI: 4.36-154.7, p<0.001). In conclusion, only 3.4% of large manufacturing factories in the Eastern Economic Corridor of Thailand complied with U.S. OSHA standards. The involvement of OHPs in this program, particularly in terms of the design for the components of the medical surveillance program through specialized organizations and the development of standardized practices is a crucial contribution.
References
Occupational Safety and Health Administration. Medical screening and surveillance requirements in OSHA standards: a guide [Internet]. 2014 [cited 2022 Dec 2]. Available from: https://kku.world/0yc3f
Craner J. Medical surveillance. In: LaDou J, Harrison R, editors. Current occupational & environmental medicine. 5th ed. New York: McGraw-Hill; 2014. p. 693–707.
Koh D, Aw TC. Surveillance in occupational health. Occup Environ Med 2003;60:705–10, 633.
Trout DB, Schulte PA. Medical surveillance, exposure registries, and epidemiologic research for workers exposed to nanomaterials. Toxicology 2010;269:128–35.
Srisook P, Chaiear N, Ekpanyasakul C, et al. A systematic review of chemical inventory required medical surveillance in the context of occupational. Srinagarind Med J 2020;35:173–81. (in Thai)
Persechino B, Fontana L, Buresti G, et al. Professional activity, information demands, training and updating needs of occupational medicine physicians in Italy: National survey. Int J Occup Med Environ Health 2016;29:837–58.
Schaafsma F, Hugenholtz N, de Boer A, et al. Enhancing evidence-based advice of occupational health physicians. Scand J Work Environ Health 2007;33:368–78.
de Boer AGEM, van Beek JC, Durinck J, et al. An occupational health intervention programme for workers at risk for early retirement; a randomised controlled trial. Occup Environ Med 2004;61:924–9.
Miller P, Haslam C. Why employers spend money on employee health: Interviews with occupational health and safety professionals from British Industry. Saf Sci 2009;47:163–9.
Martyny J, Glazer CS, Newman LS. Respiratory protection. N Engl J Med 2002;347:824–30.
Hartenbaum NP, Baker BA, Levin JL, et al. ACOEM OEM Core Competencies: 2021. J Occup Environ Med 2021;63:e445–61.
Breeher LE, Molella RG, Vaughn AI, et al. Medical surveillance programs for workers exposed to hazardous medications:a survey of current practices in health care institutions. J Occup Environ Med 2019;61:120–5.
Subsookumnuay P, Chaiear N, Krisorn P. Development of an appropriate medical certificate of employment for administrative purposes. Chiang Mai Med J 2021;60:449–62.
Department of Occupational Safety and Health, Ministry of Human Resource of Malaysia. Guidelines on medical surveillance. Putrajaya: The Department; 2001. (in Thai)
Academic Model Providing Access to Healthcare. AMPATH medical surveillance guideline. [n.p.]: AMPATH; 2014.
Occupational Safety and Health Administration. OSH act of 1970 [Internet]. 2004 [cited 2021 Feb 6]. Available from: https://kku.world/66195
Safe Work Australia. Hazardous chemicals requiring health monitoring [Internet]. n.d. [cited 2021 Feb 22]. Available from: https://kku.world/1ejka
Workplace exposure standards and biological exposure indices. Wellington: Worksafe Mahi Haumaru Aotearoa; 2020.
Froneberg B, Timm S. Country profile of occupational health system in Germany. Copenhagen: WHO Regional Office for Europe; 2012.
Rantanen J, Fedotov IA. Standards, principles and approaches in occupational health services [Internet]. 2002 [cited 2021 Feb 22]. Available from: https://kku.world/s9j5e
Conway H, Simmons J, Talbert T. The purposes of occupational medical surveillance in US industry and related health findings. J Occup Med 1993;35:670–86.
Notification of Ministry of Industry: Thailand industrial standard for chemical health risk assessment for industrial worker B.E. 2555. (A.D. 2012). Roy Thai Gov Gaz 2012;129(Special Pt 146 ng):12, 1–14. (in Thai)
Notification of Ministry of Industry: Establish industry product standards, health check-up practices based on chemical and physical risk factors from occupations in the workplace B.E. 2555 (A.D. 2012). Roy Thai Gov Gaz 2012;129(Special Pt 105 ng):6, 1–59. (in Thai)
Ministerial Regulations set the standard for employee health checks relating to risk factors B.E. 2563 (A.D. 2020). Roy Thai Gov Gaz 2020;137(Special Pt 105 ng):30–3. (in Thai)
Ministry of Public Health: Occupational health and safety and environment act B.E. 2554 (A.D. 2011). Roy Thai Gov Gaz 2011;128(Pt 4 k):5–25. (in Thai)
Ministerial Regulations on the provision of safety officers for personnel, agencies or personnel to carry out safety operations B.E. 2565 (A.D. 2022). Roy Thai Gov Gaz 2022;139(Pt 39 k):9–24. (in Thai)
Notification of Ministry of Public Health: Isclosure of personal information under the disease control act from occupations and environmental diseases B.E. 2562 (2019) B.E. 2565 (A.D. 2022). Roy Thai Gov Gaz 2022;139(Special Pt 63 ng):1–4. (in Thai)
Personal data protection act B.E. 2562 (A.D. 2019). Roy Thai Gov Gaz 2019;136(Pt 69 k):52–95.
Silverstein M. Analysis of medical screening and surveillance in 21 Occupational Safety and Health Administration standards: support for a generic medical surveillance standard. Am J Ind Med 1994;26:283–95.
Thailand Board of Investment. Thailand's Eastern Economic Corridor (EEC): industrial estate authority of Thailand [online] 2017 [cited 2021 Feb 22]. Available from: https://www.kku.world/fw43v [in Thai].
Sangphoo T, Chaiear N, Krisorn P. The proportion of medium sized manufacturing factories performing medical emergency preparedness and response according to United States Occupational Safety and Health Administration (U.S. OSHA) standards. J Med Health Sci. 2564;28:120–31. (in Thai)
Sombutteera K, Thavornpitak Y. Response rate and factors associating mailed questionnaire response rate in nursing sciences and public health research. KKU Res J (Graduate Studies) 2558;15:105–13. (in Thai)
Edwards P, Roberts I, Clarke M, et al. Increasing response rates to postal questionnaires: systematic review. BMJ [Internet]. 2002 May 18 [cited 2021 Feb 22];324(7347):1183. Available from: https://kku.world/f389b
Ishimaru T, Punpeng T, Maiyapakdee C, et al. Survey of the necessary competencies and proficiency of safety officers in Thailand. Ind Health. 2020;58:403–13.
Yiu NSN, Famakin IO. A review on safety practitioners' competency profiles from the employers' perspective. J Edu Res Rev 2021;9:77–83.
Tangyosthakijjakul S, Chernbamrung T. The appropriation of chemical and physical health risk examination of establishment in Rayong province and details of the result reporting to labor inspector. J Safety Health 2018;11:35–46. (in Thai)
Choi BCK. The past, present, and future of public health surveillance. Scientifica (Cairo) [Internet]. 2012 Oct 23 [cited 2021 Feb 22];2012: 875253. Available from: https://kku.world/76yok
Szeinuk J, Beckett WS, Clark N, et al. Medical evaluation for respirator use. Am J Ind Med 2000;37:142–57.
Kaplan B. How should health data be used? Camb Q Healthc Ethics 2016;25:312–29.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
